A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity

Objective Social, biological and environmental factors in early-life, defined as the period from preconception until age 18, play a role in shaping the risk of multiple long-term condition multimorbidity. However, there is a need to conceptualise these early-life factors, how they relate to each oth...

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Main Authors: Sebastian Stannard, Ann Berrington, Shantini Paranjothy, Rhiannon Owen, Simon Fraser, Rebecca Hoyle, Michael Boniface, Becky Wilkinson, Ashley Akbari, Sophia Batchelor, William Jones, Mark Ashworth, Jack Welch, Frances S Mair, Nisreen A Alwan
Format: Article
Language:English
Published: SAGE Publishing 2023-08-01
Series:Journal of Multimorbidity and Comorbidity
Online Access:https://doi.org/10.1177/26335565231193951
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author Sebastian Stannard
Ann Berrington
Shantini Paranjothy
Rhiannon Owen
Simon Fraser
Rebecca Hoyle
Michael Boniface
Becky Wilkinson
Ashley Akbari
Sophia Batchelor
William Jones
Mark Ashworth
Jack Welch
Frances S Mair
Nisreen A Alwan
author_facet Sebastian Stannard
Ann Berrington
Shantini Paranjothy
Rhiannon Owen
Simon Fraser
Rebecca Hoyle
Michael Boniface
Becky Wilkinson
Ashley Akbari
Sophia Batchelor
William Jones
Mark Ashworth
Jack Welch
Frances S Mair
Nisreen A Alwan
author_sort Sebastian Stannard
collection DOAJ
description Objective Social, biological and environmental factors in early-life, defined as the period from preconception until age 18, play a role in shaping the risk of multiple long-term condition multimorbidity. However, there is a need to conceptualise these early-life factors, how they relate to each other, and provide conceptual framing for future research on aetiology and modelling prevention scenarios of multimorbidity. We develop a conceptual framework to characterise the population-level domains of early-life determinants of future multimorbidity. Method This work was conducted as part of the Multidisciplinary Ecosystem to study Lifecourse Determinants and Prevention of Early-onset Burdensome Multimorbidity (MELD-B) study. The conceptualisation of multimorbidity lifecourse determinant domains was shaped by a review of existing research evidence and policy, and co-produced with public involvement via two workshops. Results Early-life risk factors incorporate personal, social, economic, behavioural and environmental factors, and the key domains discussed in research evidence, policy, and with public contributors included adverse childhood experiences, socioeconomics, the social and physical environment, and education. Policy recommendations more often focused on individual-level factors as opposed to the wider determinants of health discussed within the research evidence. Some domains highlighted through our co-production process with public contributors, such as religion and spirituality, health screening and check-ups, and diet, were not adequately considered within the research evidence or policy. Conclusions This co-produced conceptualisation can inform research directions using primary and secondary data to investigate the early-life characteristics of population groups at risk of future multimorbidity, as well as policy directions to target public health prevention scenarios of early-onset multimorbidity.
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spelling doaj-art-d2e4a293a0194beb9fb52c7a785d5ffa2024-11-27T08:03:19ZengSAGE PublishingJournal of Multimorbidity and Comorbidity2633-55652023-08-011310.1177/26335565231193951A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbiditySebastian StannardAnn BerringtonShantini ParanjothyRhiannon OwenSimon FraserRebecca HoyleMichael BonifaceBecky WilkinsonAshley AkbariSophia BatchelorWilliam JonesMark AshworthJack WelchFrances S MairNisreen A AlwanObjective Social, biological and environmental factors in early-life, defined as the period from preconception until age 18, play a role in shaping the risk of multiple long-term condition multimorbidity. However, there is a need to conceptualise these early-life factors, how they relate to each other, and provide conceptual framing for future research on aetiology and modelling prevention scenarios of multimorbidity. We develop a conceptual framework to characterise the population-level domains of early-life determinants of future multimorbidity. Method This work was conducted as part of the Multidisciplinary Ecosystem to study Lifecourse Determinants and Prevention of Early-onset Burdensome Multimorbidity (MELD-B) study. The conceptualisation of multimorbidity lifecourse determinant domains was shaped by a review of existing research evidence and policy, and co-produced with public involvement via two workshops. Results Early-life risk factors incorporate personal, social, economic, behavioural and environmental factors, and the key domains discussed in research evidence, policy, and with public contributors included adverse childhood experiences, socioeconomics, the social and physical environment, and education. Policy recommendations more often focused on individual-level factors as opposed to the wider determinants of health discussed within the research evidence. Some domains highlighted through our co-production process with public contributors, such as religion and spirituality, health screening and check-ups, and diet, were not adequately considered within the research evidence or policy. Conclusions This co-produced conceptualisation can inform research directions using primary and secondary data to investigate the early-life characteristics of population groups at risk of future multimorbidity, as well as policy directions to target public health prevention scenarios of early-onset multimorbidity.https://doi.org/10.1177/26335565231193951
spellingShingle Sebastian Stannard
Ann Berrington
Shantini Paranjothy
Rhiannon Owen
Simon Fraser
Rebecca Hoyle
Michael Boniface
Becky Wilkinson
Ashley Akbari
Sophia Batchelor
William Jones
Mark Ashworth
Jack Welch
Frances S Mair
Nisreen A Alwan
A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity
Journal of Multimorbidity and Comorbidity
title A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity
title_full A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity
title_fullStr A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity
title_full_unstemmed A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity
title_short A conceptual framework for characterising lifecourse determinants of multiple long-term condition multimorbidity
title_sort conceptual framework for characterising lifecourse determinants of multiple long term condition multimorbidity
url https://doi.org/10.1177/26335565231193951
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